Challenges And Factors Associated With Poor Glycemic Control Among Type 2 Diabetes Mellitus Patients At Nekemte Referral Hospital, Western Ethiopia
Received 27 September 2019
Accepted for publication 24 October 2019
Published 22 November 2019 Volume 2019:12 Pages 963—974
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Ginenus Fekadu,1 Kejela Bula,2 Getu Bayisa,1 Ebisa Turi,3 Tadesse Tolossa,3 Habtamu Kebebe Kasaye4
1Department of Pharmacy, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia; 2School of Medicine, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia; 3Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia; 4Department of Midwifery, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
Correspondence: Ginenus Fekadu
Clinical Pharmacy Unit, Department Of Pharmacy, Institute Of Health Sciences, Wollega University, Nekemte, Oromia, Ethiopia
Background: Diabetes is increasing at an alarming rate throughout the world, and ∼80% of diabetics live in developing countries. Similar to the rest of sub-Saharan African countries, Ethiopia is experiencing a significant burden of diabetes, with increased prevalence, complications, and mortality, as well as life threatening disabilities. Reasons for poor glycemic control among type 2 diabetes patients are complex and multivariable. Hence, this study aimed to identify challenges and factors associated with poor glycemic control among type 2 diabetes patients.
Method: A hospital-based cross-sectional study was conducted among type 2 diabetic patients attending the diabetic clinic of Nekemte Referral Hospital (NRH) from February 1 to April 30, 2018. Fasting blood glucose levels of the last three clinic visits were obtained and the mean fasting blood glucose measurement was used to determine the level of glycemic control. Analysis included both descriptive and inferential statistics with SPSS version 20.0. Predictor variable P<0.05 was considered statistically significant.
Results: Out of the total 228 included type 2 diabetes mellitus (DM) patients, 51.8% were males. The mean age of patients was 43±12.4 years and 154 (67.5%) were found to not be following their general dietary program correctly. Nearly one third, 73 (32%), of patients never attended diabetic education and 52 (22.8%) of the patients had greater than 10 years’ duration on treatment. The majority, 148 (64.9%), of patients had poor blood glucose control. Age 40–60 years (AOR=2.01, 95% CI=0.04–0.06, P=0.044), being illiterate (AOR=3.12, 95% CI=1.52–8.50, P=0.001), having informal education only (AOR=2.28, 95% CI=2.14–32.60, P=0.024), longer duration of diabetes treatment (>10 years) (AOR=3.94, 95% CI=1.51–27.83, P=0.012), inadequate physical exercise (AOR=3.19, 95% CI=1.05–19.84, P=0.019), and smoking (AOR=4.51, 95% CI=0.00–0.50, P=0.022) were independent predictors of poor glycemic control on multivariable logistic regression analysis.
Conclusion: Nearly two-thirds of patients had poorly controlled diabetes. Age, exercise, level of education, duration of the treatment, and smoking were significantly associated with poor glycemic control. Health facilities should provide continuous education, and barriers of glycemic control should be explored with further research.
Keywords: diabetes mellitus, factors, challenges, glycemic control, type 2 diabetes mellitus, Ethiopia
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